title: Quadriplegia due to lead-contaminated opium--case report.
abstract: OBJECTIVE
  Utilization of lead-contaminated opium may lead to severe motor neuron impairment and quadriplegia.
  
  
  METHODS
  Forty years oriented old male, opium addict, was admitted to the ICU, with headache, nausea and abdominal pain, and weakness in his lower and upper extremities without definitive diagnosis. The past medical and occupational history was negative. Laboratory investigation showed; anemia (Hb 7.7 g/dl), slightly elevated liver function tests, elevated total bilirubin, and ESR. Abdominal sonography and brain CT scan were normal. EMG and NCV results and neurologic examination were suggestive for Guillain-Barre. He underwent five sessions of plasmapheresis. Blood lead level was > 200 microg/dl. He received dimercaprol (BAL) and calcium disodium edetate (CaEDTA) for two five days session. Upon discharge from ICU all laboratory tests were normal and blood lead level was reduced, but he was quadriplegic.
  
  
  CONCLUSIONS
  The delayed treatment of lead poisoning may lead to irreversible motor neuron defect.
authors.affiliation: Department of Anesthesiology & Intensive Care, Imam Khomeini Hospital, Tehran Univ. of Medical Sciences, Tehran, Iran. mbage46@yahoo.co.uk
authors.forename: Mohammad Taghi
authors.initials: MT
authors.lastname: Beigmohammadi
authors.forename: Moosa
authors.initials: M
authors.lastname: Aghdashi
authors.forename: Atabak
authors.initials: A
authors.lastname: Najafi
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Mojtahedzadeh
authors.forename: Kassra
authors.initials: K
authors.lastname: Karvandian
mesh_terms: D000328:Adult; D002614:Chelating Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004112:Dimercaprol / Q000627:therapeutic use; D004340:Drug Contamination; D004492:Edetic Acid / Q000627:therapeutic use; D006801:Humans; D007854:Lead / Q000097:blood; D007855:Lead Poisoning / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D009294:Narcotics / Q000009:adverse effects*; D009293:Opioid-Related Disorders / Q000150:complications; D009892:Opium / Q000009:adverse effects*; D011782:Quadriplegia / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D002614:Chelating Agents; D009294:Narcotics; D004112:Dimercaprol; D007854:Lead; D009892:Opium; D004492:Edetic Acid